Individual
DR. ICELINI STAVERS-SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 CLAY ST, OAKLAND, CA 94612-1400
(813) 445-6182
Mailing address
1200 CLAY ST, OAKLAND, CA 94612-1400
(813) 445-6182
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
175151
CA
2084P0800X
Psychiatry Physician
270537
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03280357
—
NY
Enumeration date
05/30/2007
Last updated
05/06/2022
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